How does psychotherapy work?

This article will be useful to those who are thinking about seeking psychological help and do not yet have experience in such relationships and therapy.

1. First meeting

At the first meeting, the psychotherapist usually asks about the client’s life context, the working conditions (contract) are discussed, and the client’s primary request is clarified.

This is the most important meeting - since your success in therapy will largely depend on how comfortable you are in communicating with the psychotherapist.  As with any acquaintance, a lot depends on the first impression.  If contact has taken place, then as the psychotherapeutic relationship develops, you will trust the psychotherapist more and more and communication will become increasingly close.

Sometimes a client makes an appointment and doesn’t show up, or warns at the last moment.  On the one hand, this may be evidence of high anxiety in people who have never gone to therapy before; on the other hand, the client must understand that respect for other people’s time will not be superfluous. After all, time is allocated for him in the specialist’s schedule; he is the one they are waiting for. Therefore, even if for some reason you cannot make it to the scheduled session, try to warn in advance.

2. Contract

A psychological agreement (contract) is an oral (sometimes written) agreement to work within the framework of certain obligations.

As a rule, the minimum contract duration to achieve results is 10 meetings in the case of short-term psychotherapy.

Meetings are held once (sometimes up to three times) - since long pauses affect the quality of the work process, and frequent meetings are possible when the situation is acute or the client wants more intensive work. It is advisable that there be a gap of 72 hours (that is, 3 days) between meetings - this is important for understanding and processing the material that has emerged as a result of therapy.

At the same time, the client must understand that 10 meetings do not guarantee the desired result, this is the minimum that is necessary for changes to occur and the effect of therapy to be established. Otherwise, a “rollback” in the opposite direction may occur.

The contract also includes the price of the service, rules of attendance, and passes.

The price of therapy depends on the qualifications of the specialist and average market prices. In Kyiv, prices range from $20 to $100. Price is an important factor in therapy, and it should be tangible for the client, but not so much that he constantly thinks about it.

Free or low-cost consultations are usually devalued, and cheap dentists or hairdressers suggest the quality of their services. However, there are professional services that can provide assistance through grants or government support, but these services have their limitations.

The contract may differ from specialist to specialist, but usually the rules are the following

- session time – 50 minutes (as practice shows, this is the optimal time, it is enough)

- lateness - session time is reduced by the time you are late, so it is important to arrive on time

- notify about cancellation no later than 24 hours in advance. Otherwise, such a session is also paid. This is necessary so that missed therapy is sensitive to the client, and he does not treat therapy negligently.  This may sound harsh, but the gym does not reimburse you for missed classes.

- mandatory final meeting (some people book 2 appointments to complete therapy). You talk in advance about your desire to end therapy, without suddenly running away from the therapeutic relationship, discuss the results of therapy at this meeting and end the relationship.

This is also necessary so that if there is a crisis in therapy, which usually precedes a qualitative leap in change, the client may try to escape from therapy.  In order to level out such situations, one or more additional meetings are needed.

- meeting place (online or in person). As a rule, a psychologist does not go to a client’s home - therefore, the online format is a convenient and effective way to undergo therapy without additional loss of travel time and expenses for renting premises.

- the psychotherapist controls the degree of intimacy in the relationship in order to remain within the therapeutic relationship and so that it does not become friendly (if this happens and the client cannot stay in the therapeutic relationship, the therapy is terminated)

3. Request for therapy

A request is the problem that the client comes with. It is important to understand that at the first meeting it is the “primary request” that is spoken out, since during the process of psychotherapy it may change or lose relevance. This is due to the fact that a person usually comes with his own hypotheses about what his problem is related to, and in the course of work, other aspects that were previously not noticed by him, but more important, become clear. It is not so important that before coming to psychotherapy you have a clear formulation of your desire, the main thing is that you have this desire and have the motivation to change something. The psychotherapist will help you clarify your desire and thus you will formulate an initial request for therapy.

Each person lives in his own system of relationships, with his own unique personal history and experience. That is why the first few consultations the therapist will ask a lot of questions about life, family and biography.

4. The process of psychotherapy

There are an abundance of methods (more than 400 of them) and therefore each has its own characteristics, I will tell you how I work with my method of positive cross-cultural psychotherapy. Positive psychotherapy is one of the top ten scientifically recognized methods along with other approaches.

As part of my method, I will communicate with you and talk about what worries you, while I will pay attention to what is happening in our therapeutic contact and to your feelings . You will become more aware of your feelings and desires. During the session, I will give some exercises or techniques to work through the identified problems; at the end of the session, I will give homework. They are needed so that you can develop alternative behavior patterns. Usually homework is some kind of exercise, it doesn’t take much time to complete and is more related to awareness. And at the very end of the session we will talk about the results of the current session.

5. End of therapy

In each individual case, the client decides when he is ready to end therapy. If after the first few meetings the relationship still does not work out, then you need to look for a new therapist.  In other cases, this is determined by the dynamics of promotion on request. As I wrote earlier, 10 sessions is the  minimum number of meetings per request. Sometimes, upon completion of one request, the client moves on to work on the next one, and so on as long as it is relevant to him.

It often happens that at the end of therapy, the client switches to the format of “supportive psychotherapy” when he periodically (several times a year) meets with the therapist to share his observations, achievements and questions, receive support.

I hope this article will help you relieve the anxiety and uncertainty associated with gaining new experiences.

I can say that I would love to help you on your journey to living a more mindful life, as I do with many of my clients. To sign up for a consultation with a psychotherapist, click on the button below. 

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